Botox, Fillers, and Cosmetic Injectables

Botox injection is one of the most commonly performed cosmetic procedures in the United States and has been used to treat facial wrinkles for decades. It is also generally considered to be extremely safe with minimal side effects. Botox works by relaxing wrinkle-forming muscles in order to both soften fine wrinkles as well as prevent further development and worsening of wrinkles.

Our surgeons perform a high volume of Botox injections for patients our office, with various techniques including using micro injection needles to minimize discomfort and bruising. There is minimal down time, and patients often return to work on the same day. The effects from Botox injections typically begin to appear over the first week and generally last approximately 3 months. Botox injections can work wonderfully for dynamic wrinkles (wrinkles that appear with facial movement/expressions), as well as softening deeper static wrinkles (wrinkles that are always visible). However, facial filler injection may also be needed to treat static wrinkles. Botox injection, when performed on a regular and ongoing basis, can be a powerful tool in preventing wrinkle formation and help you achieve your goals in aging gracefully.

• Frown lines between the eyebrows, also known as “glabellar lines” or “11 lines”
• Forehead wrinkles, which appear when you raise your eyebrows
• Smile lines on the sides of the eyes, also known as “Crow’s Feet”
• Lower eyelid rolls, which appear as fullness of the lower eyelid with smiling
• “Bunny lines”, which are wrinkles on either side of the nose during certain facial expressions
• “Smokers lines”, which are wrinkles around the lips
• Botox injections can also be used to
  • subtly provide a lateral “non surgical eyebrow lift”
  • treat downturned corners of the mouth (frowning appearance)
  • reduce a “gummy smile” where a large part of the gums are revealed when smiling

As we age, facial volume is frequently lost and/or redistributed within unwanted sections of the face.  This facial aging process often transforms a youthful, heart-shaped face, into a more square-shaped face with deeper wrinkles.  With these changes, we often lose our cheekbones, develop deepening of the tear-trough under the eyes, as well as deepening of other wrinkles and folds on the face. Fortunately, there are a number of safe and effective products that can help restore a more youthful appearance without surgery.

We exclusively use hyaluronic acid fillers, such as Restylane and Belotero Balance, because this is the safest type of fillers on the market. These are also the most suitable fillers for use around the eyes. Hyaluronic acid naturally occurs in the human body, and therefore is generally well accepted by the body and carries a low risk of side effects. The hyaluronic acid fillers do an excellent job at filling both deeper folds and creases as well as smoothening out wrinkles.

• Nasolabial folds: the deep groove that extends from the corner of the nose to the corner of the mouth
• “Marionette lines”: the groove that extends from the corner of the mouth downwards towards the chin.
• Lip augmentation. Read more about lip augmentation using fillers.
• Reducing fine wrinkles such as smile lines also known as “crow’s feet” , vertical lip lines also known as “smokers lines”, and mental crease (chin crease)
• Tear trough deformity, one of the key contributors for the appearance of dark circles under the eyes, or lower eyelid bags.
• Upper eyelid hollowness, which can make the eyes look tired, aged, and even unhealthy.
• Cheek augmentation can help to restore loss of mid-facial volume which is common with aging.
• Jaw line rejuvenation can provide a more youthful and straighter jaw line

• The anatomy around the eyes is highly complex
• The skin around the eyes are the thinnest and most delicate in the body
• If performed by an injector not familiar or experienced with the areas around the eyes, Botox and filler injections can be highly challenging and even dangerous. This, in the worst-case scenario, can even lead to blindness.
• Dr. Shannon S. Joseph is an oculofacial plastic surgeon and Dr. Andrew W. Joseph is a facial plastic surgeon who have a thorough understanding of the anatomy around the eyes and is highly specialized and experienced in both surgical and non-surgical treatments around the eyes and face. Learn more about why patients choose us.

Our goal is to help you feel confident in your appearance and love the way you look. With our non surgical treatments, including Botox and facial fillers injections, or a combination of these treatment modalities, we can help you achieve a youthful look that will make you feel more confident every day with minimal downtime. Sometimes non surgical options would not be sufficient. In those cases, surgical procedures such as upper blepharoplasty,  lower blepharoplasty, brow or forehead lift, or fat grafting may be excellent options for you.

At your one-on-one consultation, Dr. Joseph will listen to your goals, and perform a comprehensive evaluation. She will then work together with you to identify the treatment options that are best suited for your needs.